RESEARCH & EVALUATION

Transcription

1 CYPD CHILD PROTECTION RESEARCH & EVALUATION Family based intervention against child abuse and neglect for young parents involved in a youth and livelihoods program in Liberia: A pilot project to build evidence around the potential for parenting skills trainings to protect children from abuse, neglect, and exploitation NOVEMBER 2011 From Harm to Home Rescue.org

2 Contents Acknowledgements... 3 Abbreviations... 4 Executive Summary... 5 Section 1: Background The case for family-strengthening interventions with a nurturing parenting component in Liberia Overview of the IRC s Parenting Program for Young Mothers in Liberia... 8 Section 2: Methodology Overview Limitations and Challenges Informed Consent and Confidentiality Section 3: Research Findings Demographics Research Question 1: What are the most problematic parenting practices in Liberia? Research Question 2: Can the group of young mothers acquire parental skills through a short training program? Do young parents change parental behaviour or are they willing to change their parenting behaviours after a parenting skills training? Research Question 3: Is the program selected suitable for the Liberia context? Can it be replicated? Why? Additional findings of interest Section 4: Recommendations and Conclusion: Works Cited Appendix A: Baseline Assessment Focus Group Discussion Guide Appendix B: Evaluation--Fidelity and Acceptability Questionnaire and Focus Group Discussion Guide Appendix C: The adapted Adult-Adolescent Parenting Inventory (AAPI-2)

3 Acknowledgements This research is the result of a collaborative effort between the International Rescue Committee s Child and Youth Protection and Development Technical Unit, the IRC country team in Liberia, and Family Development Resources, Inc. Nurturing Parenting Programs trainer and consultant Bettie Murchison played a vital role in the development and implementation of the pilot project by collecting baseline data, adapting a Nurturing Parenting Program curriculum, training the trainers, and assisting in the analysis of program results. Dr. Stephen Bavolek, President of Family Development Resources, Inc. and Executive Director of the Family Nurturing Centers, authored the Nurturing Parenting Programs and played an advisory role throughout the life of the pilot project. This research would not have been possible without the efforts of the IRC s staff in Liberia including Child and Youth Protection and Development Coordinator, Sandra Maignant; Project Manager, Abu Macpherson; Monitoring and Evaluation Officer, Dominic Massaquoi; and Private Sector Liaison Officer, Issac Capehart. Special thanks to the Economic Empowerment of Adolescent Girls and Young Women Program (EPAG) trainers and to the young women who joined the program enthusiastically and want more than anything a better and happier life for their children. 3

4 Abbreviations AAPI: Adult/Adolescent Parenting Inventory CYPD: Child and Youth Protection and Development EPAG: Empowerment of Adolescent Girls and Young Women Program I/NGOs: International/Non-governmental Organizations NPP: Nurturing Parenting Programs The IRC: The International Rescue Committee UNICEF: United Nations Children s Fund 4

5 Executive Summary Family Based Intervention against Child Neglect and Abuse for young parents involved in a Youth and Livelihoods program in Liberia was a pilot project to address the family-based protection risks facing children in Liberia; advance the Child and Youth Protection and Development Unit s (CYPD) technical priorities; and respond to the gap in knowledge around the adaptability, acceptability, effectiveness, and scalability of parenting program models implemented in conflict, post-conflict and disaster affected settings. Between December 2010 and April 2011, the pilot parenting program provided approximately 200 young mothers between the ages of 17 and 31 with a ten session parenting program. The pilot parenting program utilized the Nurturing Parenting Programs Easy Reader Curriculum and was implemented through the existing training and program structure of the IRC s Empowerment of Adolescent Girls and Young Women Program (EPAG), a three year initiative supported by the World Bank, the Nike Foundation, the Government of Denmark and the Government of Liberia. As part of the IRC s commitment to implementing programs that are both evidence based and evidence generating, with the pilot project, the CYPD unit s child protection team set out to answer the following questions: 1. What are the most problematic parenting practices in Liberia? 2. Can the group of young mothers acquire parental skills through a short training program? Do young parents change parental behavior or are they willing to change their parenting behaviors after a parenting skills training? 3. Is the program selected and adapted suitable for the Liberia context? Can it be replicated? Why? This paper provides an overview of the pilot project, Family Based Intervention against Child Neglect and Abuse for young parents involved in a Youth and Livelihoods program in Liberia, presents the findings from the pilot project; and provides insight into the strengths and weaknesses of the research methodology. Finally, this paper offers recommendations to guide future research and monitoring and evaluation efforts and to inform the implementation of future phases of the IRC s parenting program for young mothers in Liberia, the first of which is being implemented as an integrated part of the EPAG program s second round of trainings. 5

6 Section 1: Background It is widely acknowledged that protecting children from abuse, neglect, exploitation and violence requires interventions that strengthen the protective capacities of each layer of children s ecological system. Such interventions are essential to children s survival, development, and psychosocial wellbeing. This is particularly true in conflict, disaster and post-conflict development settings where family, community, and national level protective systems are often weak and fragmented. 1 In these settings, I/NGOs, working with local and national level counterparts, have taken steps to strengthen the protective capacities of government systems, schools, community groups and children themselves. However, although families play the most significant role in children s protection and development (Brofenbrenner, 1979) in conflict, disaster, and post-conflict settings, interventions aimed at strengthening the capacity of families to protect, nurture, and provide for their children have been limited and little evidence exists as to which family-strengthening models best address children's protection needs in these contexts. To address this gap in knowledge and service, the child protection team under IRC's Child and Youth Protection and Development Unit has identified family-strengthening interventions as a technical priority 2. Drawing on an extensive literature review and meetings with leading academics and child protection practitioners, the IRC has piloted different kind of projects for family-strengthening that may be successful in enhancing the capacities of families to protect, nurture and provide for children in conflict, disaster, and post-conflict settings. These include: (a) programs that support income generation and provide an added component of group discussion around positive discipline practices and children s rights; (b) programs for both parents and children that aim to strengthen parent-child interactions; and (c) parenting skills training. While there are a number of existing, evidence-based and promising program models that fall into these categories, research is needed to identify which program models are most adaptable, acceptable, effective, and scalable in resource poor, disaster, conflict, and postconflict settings. 1 Machel, 1996; UNICEF, 2006; Boothby, Strang & Wessels, 2006; Levy-Shiff, Hoffman, & Rosenthal, Technical priorities are areas where the IRC actively seeks to develop knowledge and expand programming. This 2 Technical priorities are areas where the IRC actively seeks to develop knowledge and expand programming. This entails conducting literature reviews; piloting evidence based models; generating evidence; and further integrating technical priorities into our existing programming. 6

7 1.1 The case for family-strengthening interventions with a nurturing parenting component in Liberia Liberia suffered a brutal and devastating civil war from 1989 until The war resulted in over 200,000 deaths and led to the internal and external displacement of hundreds of thousands (LISGIS, 2007). By the end of the war, Liberia s infrastructure was destroyed, the social fabric was torn and a whole generation of Liberians had grown up without access to basic educational and health services (the IRC, 2010). 3 Although Liberia is no longer in an acute emergency phase, the transition from conflict to social and economic stability and development is rife with challenges, particularly for children. Today, the government of Liberia is ranked as one of the least child-friendly in Africa (ranked 47th out of 52 countries) due to the lack of legal mechanisms for child protection and a grossly inadequate budget allocated to address children s protection and development needs (Forum, 2008, pp. 7-8). According to UNICEF Statistics on Liberia, 25% of children under five are moderately or severely underweight ; 21 % are engaged in child labor; and less than 5% of children under the age of 5 years have registered births (UNICEF, 2010). Particularly salient for the IRC s family strengthening efforts is the fact that many children in Liberia are living in households with only one parent or with caregivers who are not their biological parents. In Monrovia, 25.9 % of girls and 32.9% of boys between the ages of 10 and 14 lived with only one parent, most commonly, the mother ( UNFPA and Population Council, 2008, p. 15); and 42.3 % of girls and 33.3% of boys in this age group lived with neither parent in the household ( UNFPA and Population Council, 2008, p. 15). In Liberia, the high rates of children living with neither parent or with only one parent, combined with the high rates of poverty (UNDP, 2010) are concerning. Caregivers are responsible for protecting children from physical harm and ensuring that their nutritional, medical, and educational needs are met. They also play a significant role in children s social, emotional and intellectual development and ability to cope with stressful and traumatic situations (Smokowski, 1998; Masten, 2001) including natural disasters and conflict. However, as acknowledged by Secretary-General Ban Ki-moon in his Message for 2011, when families face enduring hardship, children's needs are often neglected and children are left with "lifelong physical and cognitive scars." Children living in foster families where resources are stretched thin may be particularly vulnerable. 4 Children of young single mothers may also face heightened risk due to the low earning, protection and social power of women in Liberia, (UNFPA and Population Council, 2008, p.13). This may be particularly true when the young mother lacks social support systems, including strong family relationships (Flanagan P, 1995). 3 The IRC. Liberia Country Profile. (2010). 4 According to Reaching Out to Africa s Orphans: A Framework for Public Action (2004), orphan care tends to fall on the poorest households and reduces consumption and resources per capita (Subbarao, 2004, p. 14). 7% of children in Liberia are orphans (Liberia Insititute of Satistics and Geo-Information Services (LISGIS) [Liberia], 2007, p. 10) 7

8 According to the 2007 Demographic and Health Survey (DHS), children in Liberia experience alarmingly high rates of physical and psychological punishment. In the month prior to the DHS survey, 83% of children between the ages of 2 and 14 had experienced psychological punishment such as yelling and name calling; 76% had experienced minor physical punishment (being slapped on the face head, arm or leg); and 15% had experience severe physical punishment such as severe beating with an object (LISGIS, 2007, p. 47). Common, traditional methods of discipline in Liberian culture include beating children with objects such as switches or belts or rubbing hot pepper in children s eyes and mouths or on their genitals (Schmidt, 2009, p. 9). In line with the high rates of physical and psychological punishment experienced by children in Liberia, corporal punishment has traditionally been seen in Liberia as not only accepted but as necessary to prepare a child to be a good citizen (Schmidt, 2009, p. 9). 1.2 Overview of the IRC s Parenting Program for Young Mothers in Liberia Family Based Intervention against child neglect and abuse for young parents involved in a youth and livelihoods program in Liberia 5 was designed as a pilot project to address the family-based protection risks facing children in Liberia; advance the Children and Youth Protection and Development (CYPD) unit s technical priorities; and respond to the gap in knowledge around the adaptability, acceptability, effectiveness, and scalability of parenting program models implemented in conflict, post-conflict and disaster affected settings. The proposal was developed with the invaluable support of the IRC-Liberia country team and was part of a collaborative effort between the Child Protection and the Youth and Livelihoods subsectors within the Child and Youth Protection and Development technical unit. Funding was awarded in August Program Selection The IRC selected Nurturing Parenting Programs Trainer, Bettie Murchison, and Family Development Resources, Inc., publisher of the Nurturing Parenting Programs, as partners for the implementation of the pilot project. Nurturing Parenting Programs was chosen because: 1) it was backed by a number of validation studies and was therefore in line with the IRC s commitment to implementing evidence based programs; 2) it included evidence-based methods for pre and post evaluation of participants, namely the Adult and Adolescent Parenting Inventory-2 (AAPI-2); 3) the program was possible to implement at a low-cost in resource poor environments; 4) it had been implemented successfully with diverse populations; and 5) it included curricula for participants with low-levels of literacy for the welfare system in the US. Nurturing Parenting Programs Nurturing Parenting Programs (NPP), authored by Family Development Resources, Inc. President, Dr. Stephen Bavolek, include a range of parenting curricula and tools designed to treat and prevent child abuse and neglect. Because positive (and negative) parenting beliefs and practices are learned, the programs are targeted at helping parents develop the skills and knowledge that they need to be 5 From here on referred to as the Parenting Program 8

9 nurturing parents. The program focuses on building parents competency in five areas: (a) appropriate expectations of their children; (b) empathy; (c) understanding of positive discipline practices; (d) understanding of appropriate parent-child roles; and (e) healthy beliefs towards children s power and independence. The programs have been implemented with Haitian, Arab, Hispanic, African-American, Caucasian, Somali, and Hmong populations in the United States, as well as with U.S military families abroad. The effectiveness of the NPP curricula and the reliability of the AAPI-2 has been demonstrated through a number of validation studies 6 conducted in the United States. Program Participants Implementation of the pilot program The IRC s Parenting Program was implemented through the IRC s Empowerment of Adolescent Girls and Young Women Program (EPAG), a three year initiative supported by the World Bank, the Nike Foundation, the Government of Denmark and the Government of Liberia. The EPAG program aims to provide business and life skills training to adolescent girls and young women in five communities (New Kru Town, Doe, Red Light, West Point, and Bentol). The first round of EPAG training was conducted between March 2010 and December 2010 and benefited 355 adolescent girls and young women. Of these participants, 263 volunteered to participate in the IRC s pilot parenting program. The pilot parenting program was facilitated in each of the five communities by EPAG trainers. The decision to implement the pilot parenting program through the EPAG program was made because working through the existing training structure was time and cost effective and because many of the EPAG trainees are young, poor, single mothers who the IRC Liberia program staff believed could benefit from parenting support. The baseline assessment and adaptation phase of the program began on August 2010, with the pilot parenting program running from December 15, 2010 to April 28, We set out to answer three research questions: 1. What are the most problematic parenting practices in Liberia? 2. Can the group of young mothers acquire parental skills through a short training program? Do young parents change parental behavior or are they willing to change their parenting behaviors after a parenting skills training? 3. Is the program selected and adapted suitable for the Liberia context? Can it be replicated? Why? 6 NPP validation studies can be found at 9

10 Section 2: Methodology 2.1 Overview The Parenting Program was implemented in four phases. See below Table 1: Table 1. Overview of pilot parenting program activities Phase Description Components Phase One (August/September 2010) Phase Two (November/December 2010) Phase Three (December May 2011) Baseline Assessment and Adaptation Training of Trainers Parenting Program Implementation Literature Review Focus group discussions and cultural validation session AAPI-2 adaptation AAPI-2 pre-test for trainers Training of trainers to administer the AAPI-2 Selection of participants AAPI-2 pre-test for young mothers who signed up to participate in the parenting program Curriculum identification and adaptation Literature Review (continuation) Fourteen trainers were trained during a fourday training in Liberia Implementation of a ten session training program on a bi-weekly basis in five communities over the course of five months. Phase Four (May-August 2011) Post-program assessment AAPI-2 post-test for participants and trainers. Semi-structured focus groups with participants. Put the number of focus groups completed Semi-structured interviews with trainers. Put the number of interviews Analysis of data from matched pre and post AAPI-2 tests. For trainers and participants 10

11 Phase One ~ Baseline Assessment and Adaptation The first phase of the pilot project began in August 2010 with a brief literature review and planning meetings with the IRC Liberia staff. Following the preparatory work, in September 2010 the Nurturing Parenting Programs Trainer and the IRC s Child Protection Technical Advisor visited the IRC Liberia country program to: conduct focus group discussions with EPAG trainers and trainees to identify common discipline practices in Liberia and inform the selection and adaptation of the Nurturing Parenting Program curriculum; assess EPAG trainers perceptions of the acceptability of the Adult/Adolescent Parenting Inventory; train fourteen EPAG trainers on how to conduct the Adult/Adolescent Parenting Inventory (AAPI-2); and determine the baseline parenting beliefs of the trainers and trainees through the AAPI-2 pretest. Trainers took the AAPI-2 pre-test before their 4-day training; participants took the AAPI-2 pre-test before beginning the Nurturing Parenting Program curriculum. Focus Groups Discussions and Cultural Validation Session Five group discussions were held with participants in the EPAG training program in the five communities in which the EPAG program is operational (New Kru Town, Doe, Red Light, West Point, and Bentol). These were intended as focus group discussions for 8-10 trainees; however, the number of participants in the groups exceeded this in 4 of the 5 communities: 7 participated in New Kru Town, 22 in Bentol, 44 in Doe, 14 in Redlight, and 27 in Westpoint. In light of these large numbers, the focus group discussions instead became large group discussions. As participants in these five group discussions were EPAG trainees, all were females between the ages of 17 and 31 and had similar educational and economic backgrounds. For a more comprehensive picture of common parenting practices in Liberia, the IRC s Child Protection Advisor and the NPP Trainer held three additional focus group discussions: one contained eight female Liberian IRC staff members with different educational and economic backgrounds; one included seven EPAG trainers; and the other contained six EPAG trainers. The questions posed to participants in each of the eight groups were consistent and can be found in Appendix A. At the end of the field visit, a validation session was held with three EPAG mentors and three supervisors 7 to verify information received in the focus groups and gain input to guide the program design. To ensure stakeholder support for the program communities were informed in advance, but as the program was under the implementation of a larger EPAG intervention, special meetings with community leaders were judged not to be necessary by the IRC Liberian personnel. 7 Mentors are older women that serve as role models and advisers to the EPAG participants in their own communities. Supervisors play a management role working with trainers and other EPAG personnel. 11

12 The AAPI-2 Assessment The AAPI-2 assessment was the primary instrument used to collect quantitative data at baseline and endline regarding the parenting and child-rearing beliefs of adult and adolescent parent participants and trainers. The assessment was filled out by participants themselves using pencil and paper; each question was read aloud giving participants time to write the answer though a multiple choice methodology. The AAPI-2 assessment contains forty questions designed to identify parenting beliefs with a known correlation to abusive childrearing behaviours. These parenting beliefs fall into five constructs: (a) inappropriate parental expectations; (b) lack of an empathetic awareness of children s needs; (c) belief in the use and value of corporal punishment; (d) parent-child role reversal; and (e) oppressing children s power and independence. The AAPI-2 is a norm-referenced inventory. As such, raw scores are converted into sten scores (based on a standard ten scale), which identify where an individual stands in relation to a normal distribution of scores (Bavolek, 2005). Sten scores range from Low sten scores (1-3) have been demonstrated to indicate a high risk for abusive parenting behaviours; scores ranging from 4-7 represent the normal range of parenting beliefs and moderate risk for abuse. High sten scores (8-10) indicate positive, nurturing parenting beliefs. Research has revealed that the correlation between raw scores in the five construct areas and abusive parenting behaviours varies depending on age and gender. For this reason, separate norm tables have been established and tested for male and female adults and adolescents. Separate norm tables also exist for Haitians, Arabic populations, Hispanic populations, and Asian populations in the U.S as a result of the AAPI-2 being translated, thus resulting in a different inventory. In the past, separate norm tables were also developed for Caucasians, Hispanics, and African-Americans in the U.S. The AAPI-2 has since been re-normed to account for differences between these groups which likely correspond more to income and education than to race or culture. However, as no normative scale currently exists for Liberians, the normative scale for African-Americans was used to determine the sten scores of the pilot project participants. The decision was made based on perceived similarities between the two groups: poverty, low education, poor health resources, high degree of violence. Adaptation of the AAPI assessment The Nurturing Parenting Programs Trainer and the IRC Child Protection Technical Advisor (CP TA) conducted semi-structured focus group discussions with seven EPAG trainers and supervisors to get feedback on the relevance of the items in the AAPI-2 assessment. Adaptations were made to the AAPI-2 assessment based on this feedback. Questions regarding race, nationality, and income were removed, and questions including number of children delivered, number of children still alive, and tribe/community were added. The word spanking was replaced with beating; potty training was replaced with chamber or stool; wellbeing and nurture were replaced with take care of; confide was changed to tell secrets; and strong willed was changed to strong opinions. Dr. Stephen Bavolek approved all changes to the AAPI-2 assessment to ensure that they did not affect the integrity of the assessment or results. 12

13 Selection of Participants Participants in the pilot parenting program were selected on the basis of their participation in the EPAG trainings; having at least one child; and participating voluntarily in the pilot parenting program. By nature of their being part of the EPAG program, program participants fulfilled additional criteria of having dropped out of school and having basic numeracy and literacy skills 8. AAPI-2 Pre-tests The NPP Trainer and the IRC Child Protection Technical Adviser administered the adapted AAPI-2 to the fourteen EPAG trainers who would be facilitating the IRC s Parenting Program for Young Mothers in Liberia. The EPAG trainers were then trained fastidiously on how to administer the AAPI pre-test to program participants. A total of 263 AAPI-2 pre-tests were administered: 67 in Bentol; 58 in Doe; 54 in New Kru Town; 45 in Redlight; and 39 in West Point. Curriculum identification and adaptation Taking into account the low literacy levels of the trainees, AAPI-2 assessment results of trainers and trainees, and findings from the group discussions, the IRC and the NPP Trainer identified the Easy Reader Nurturing Parenting Program for Parents and Their Infants, Toddlers and Preschoolers as the most suitable for the Parenting Program. Due to time and financial resources constraints, the fiftysession curriculum was consolidated into ten two hour sessions that focused on those construct areas that the focus group discussions and AAPI assessments revealed as most needing improvement: Session One: Nurturing as a Lifestyle; Session Two: Children s Brain Development; Session Three: Ages and Stages; Session Four: Developing Empathy/Getting Needs Met; Session Five: Recognizing, Understanding and Handling Feelings; Session Six: Building Self-Worth and Personal Power; Session Seven: Discipline with Dignity Techniques to Use; Session Eight: Family Rules/Rewards & Punishment/Praise; Session Nine: Touch History/Stress and the Need for Nurturing Routines; and Session Ten: Anger, Criticism/Confrontation, and Violent Relationships. The Easy Reader parent handbooks that are designed to accompany the sessions were adapted to reflect the changes that were made in the number of sessions. 8 Participants in the EPAG program are also supposed to be between the ages of 16 and 27. Dates of birth show that the age range may actually be and that participants in the pilot parenting program were between the ages of 17 and

14 Phase Two ~ Training of Trainers (ToT) In the second phase of the project, the Nurturing Parenting Programs Trainer and the IRC Child Protection Technical Advisor conducted an intensive four-day training to the fourteen EPAG trainers and supervisors who would facilitate the parenting program. Because the AAPI scores of the EPAG trainers were below the recommended scores for well-prepared trainers 9 (according to NPP, effective trainers should score in the low-risk category), the ToT modules were adapted to include cognitive and affective ways of introducing nurturing parenting concepts. Training modules included: Nurturing Parenting Constructs; Brain development; Philosophy, Morals and Values; Communication Skills; Basic Needs and How to Get Them Met; Conflict versus Confrontation. Facilitation Tips; Data Collection and Implementation; Program Fidelity; Phase Three ~ Implementation of the Parenting Program The parenting program began on December 15, 2010 following the first round of EPAG business and life skills training. Each community had two trainers (one male and one female), with the exception of New Kru Town, which had four trainers (2 males and 2 females) as the community was divided into two groups for the EPAG business and life skills training sessions that are independent from this research. Ten 2-hour sessions were conducted over the course of five months, concluding on April 28, Table 2 outlines the training sessions by community, month, topic, construct and number of participants in attendance. Attendance keeping records were poor, as no names were recorded at the beginning and at the end of each session. This, combined with a lack of punctuality, may have caused inaccuracies in attendance records.. 9 The average trainer score on a standard ten scale was 2.64 in Construct A: Parental expectations; 2.91 in Construct B: Empathetic awareness of children s needs; 4.82 in Construct C: Belief in the use and value of corporal punishment; 1.91 in Construct D: Parent-child role reversal; and 4.36 in Construct E: Oppressing children s power and independence. 14

15 Community Table 2. Pilot parenting program training sessions and AAPI pre and post-tests, by community Month: Dec. Jan. Feb. March April Session: Construct: B A A B B B B A A B D B B D C D C B B C D D E D C C D E D D E E Community: # of AAPI Pre-Tests # of participants by session # of AAPI Post- Tests # of Matched AAPI Post- Tests Bentol Doe New Kru Town Westpoint Redlight TOTALS: Construct A: Appropriate expectations Construct B: Empathy Construct C: Corporal Punishment Construct D: Parent-Child Roles (Self-Awareness) Construct E: Children s Power and Independence Attrition As can be seen in Table 2, in all communities except Bentol, attendance records show high rates of attrition between the first and final sessions. Attrition rates are particularly high in Doe (50%) and New Kru Town (29.82%). Qualitative data from post-program questionnaires given to trainers and postprogram focus groups with participants to assess program fidelity and acceptability provide some insight into the main causes of attrition: lack of payment, transportation, and employment or schedule conflict. 15

16 Lack of payment According to trainers in Doe, lack of payment for attendance in the session was an obstacle to attendance and motivation, particularly since attending sessions required participants to leave their businesses. According to one trainer: What was difficult about the program was the issue of cards to call trainee for session because we have to call more than two times to come to session meaning before training day and on the day of training. Also some complain that they would love for funds to be made to them instead of Snaps 10 because they will leave their businesses to come for session and they are engage in susu 11, so if they leave their businesses how will they pay their susu at the end of the day. According to another: Supplies were made available to trainee to keep the session on (snaps) but most of them complain that they prefer money be given to them. The problem of lack of payment, while particularly acute in Doe, was also seen in other communities. As stated by one participant in Redlight for example: The biscuit and drinks was a serious problem for the sessions as it serve as a de-motivating factor. As Africans, we need heavy food or the equivalent in money. Transportation Transportation challenges also affected attendance. From the start, there was problem. And the problem was about refreshment, one trainer in New Kru Town reported. Participants said they needed transportation allowance. Instead of what was given them for refreshment. This challenge was echoed by participants in New Kru Town and Bentol. According to one participant, there was something about the program that created problem. I had problem sometimes coming to session. I never had transportation all of the time. So I feel so hurt if I don t come or if I missed session. According another participant, The juice and biscuit was okay but transportation was a problem making most of us to come late to sessions as we live far from the training. Employment/schedule conflict Attendance in the sessions was also problematic as many of the participants were employed or had their own businesses to run. Several participants reported having to miss whole or partial sessions due to work and trainers in each of the communities mentioned difficulty in gathering participants for the sessions. One participant said: Every time I didn t attend a session was either I didn t have someone to leave at my business or I went to go and buy my goods. In the words of one trainer in Redlight: There were few things that made the program difficult and created problems: getting the girls to come due to their business schedules; getting them to come on 10 Snaps is a soft-drink that was provided to participants as refreshment during the sessions 11 Susu is a traditional form of banking in Liberia similar to a rotating savings and credit association. 16

17 time and together; and less scratch 12 cards to contact the girls. According to another in New Kru Town, I could not start session on time because I had to get these girls from their homes or business sit before starting session. It was really difficult getting these girls. Despite the challenges, trainers and participants alike reported that when participants began to appreciate what they were learning in the parenting program, many of the challenges, particularly those related to payment and refreshments, became less problematic. As stated by a participant in the postprogram focus group session in New Kru Town, At first we complain about leaving our various business areas and homes and even about the refreshment given us but we later realize that we were benefiting or learning something. Pre and Post Tests Of the 263 participants who took the pre-tests, fewer took both pre and post tests. The post-test was administered at the end of the last session; however, only 74% of participants in the last session took the post-test. This is particularly marked in Redlight where only 54% of participants in the last session took the post-test and in Bentol where only 69% took the post-test. Interestingly, in both communities, attendance records provided by the trainers show nearly perfect attendance (after the initial drop outs in Redlight). The IRC Liberia country team reported that Bentol participants were particularly motivated and interested in the program, but could not explain why few completed the post-test. Phase Four ~ Post-Program Assessment To assess the impact of the parenting program on participants and trainers parenting beliefs in the five construct areas and to determine their risk for abusive behavior, the sten scores of the AAPI-2 pre-tests were compared with those from the AAPI-2 post-tests. Of the 142 post-tests administered by the trainers at the end of the final session and entered into the database, only 138 were matched, meaning that the participant had also taken a pre-test. Of these, 2 were disregarded as a result of duplication. As a result, only 136 matched tests were considered in the data analysis. After the AAPI-2 post-tests had been administered, discussion groups were carried out with trainees in each community to collect qualitative information regarding participant satisfaction with the program. 20 EPAG trainees participated in Doe; 40 in New Kru Town; 30 in Westpoint; 35 in Redlight, and 68 in Bentol. To assess trainer fidelity to the program, trainers were provided with a short questionnaire. The discussion questions and the trainer questionnaires can be found in Appendix B. 12 Scratch cards contain credit for phone use that made possible contacting participants in the parenting pilot project. 17

18 2.2 Limitations and Challenges Assessment and monitoring plan Although the research questions were clearly stated at the outset of the project, the data collection process and methods were limited. Data collection methods heavily relied on the quantitative AAPI-2 methodology which was not sufficient to answer all research questions adequately, particularly question 2. No processes were in place to assess trainer fidelity to the program or to adequately track unique participant attendance per session. Attendance was tracked by number of participants in each session, rather than by individual participant participation in sessions at the beginning and at the end. This posed challenges for adequately monitoring attendance and exposure to the program, limiting the extent of analysis that could be done to determine factors contributing to attrition or to identify the effect of attendance on AAPI-2 results. Focus Group Discussions Focus group discussions provided invaluable qualitative data. A number of challenges were posed, however, by the way in which focus group discussions were conducted. During the focus group discussions that were held during the baseline assessment, the number of participants was not restricted and thus a core requirement for a focus group discussion was not met (small group size of between 5-8 participants, and a controlled process and environment). The process for data collection relied solely on facilitators note taking. In the focus group discussions that were held at the end of the program, the extent of detail provided in facilitator notes varied greatly by community and facilitator. Brief summaries were often provided rather than direct quotes and notes taken by trainers who facilitated the focus group discussions provided no indication of how many participants contributed to the discussion. Weaknesses in the qualitative data collection, particularly during the evaluation phase, can be attributed to insufficient training in qualitative data collection and insufficient planning and preparation. Selection bias There were high rates of attrition. Those who stayed in the program may have been more open than those who left the program to learning new ways to improve their parenting. AAPI-2 Norm Table The AAPI-2 was not re-normed for Liberians. Rather, the normative table for African-Americans was used. Although there are similarities between populations (i.e poverty, low education, and poor health resources), whether or not the normative scale for African-Americans provides an adequate assessment of the child protection risk associated with parenting beliefs in Liberians is unknown. 18

19 AAPI-2 trainer's scores Despite the training on nurturing concepts, the fact that the EPAG trainees scored low on the APPI-2 constructs, could have affected the positive results of the program. The correlation between trainer and participant scores is further explored on page 36. Curriculum adaptation The drastic consolidation of the curriculum from 50 to 10 sessions could have affected the positive results of the program. 2.3 Informed Consent and Confidentiality Participation in the focus group discussions was voluntary. The Nurturing Parenting Programs Trainer and the IRC Child Protection Technical Advisor who facilitated the focus group discussions as part of the baseline assessment explained to the participants how the information collected during the focus groups would be used. In order to ensure anonymity, names of participants were not documented during the focus group discussions. Oral consent was gained. Before administering the AAPI-2 pre-tests, participants were introduced to the purpose and background of the AAPI-2 as well as to how the IRC planned to use the data. The IRC staff informed participants in the parenting program as well as trainers that participation in the AAPI-2 tests was voluntary and that their participation in the program would not be affected by their participation in the AAPI-2 or by their scores on the test. 19

20 Section 3: Research Findings 3.1 Demographics According to reported birthdates, the 136 participants who took both the AAPI-2 pre and post tests were between the ages of 17 and 31. The reported ages of participants at the time of the pre and post tests, however, varied significantly. Reported ages ranged from according to the AAPI-2 pretests. Post-tests for the same participants seven months later showed ages ranging from 17-31, and the frequency of ages within this age range differed noticeably. It is worth noting that the dates of birth reported during the AAPI-2 tests were often inconsistent with those documented in the EPAG Trainee Directory, though the age range according to dates of birth is similar. Having at least one child was required for entry into the program. Although the data collected pre and post test was inconsistent, the majority of participants reported having 1-2 living children. Two participants during the pre-test, and one during the post test, reported having no children. #of children delivered who are still alive # of Participants Pre-Test Table 3: Number of Children % of participants # of Participants Post-Test % of participants 0 2 1% 1 1% % 48 35% % 49 36% % 27 20% 4 3 2% 10 7% 5 0 0% 1 1% Results of the pre and post-tests indicate that the majority of participants had education beyond grade school. However, as shown in Table 4, there were inconsistencies in the data collected in the pre and post tests. Table 4: Highest level of education completed according to participants (% ) Pre-Test Post-Test Grade School 40% 25% High school 4% 24% Some college 13% 4% 7th grade 7% 9% 8th grade 9% 9% 9th grade 6% 11% 10th grade 8% 5% 11th grade 6% 7% Unknown 7% 6% 20

21 According to AAPI-2 post-tests, the majority of participants were unemployed (49.3 %); however, a comparision of the pre and post tests shows that durin the post tests, a larger percentage of participants self-identified as employed full-time (11.8% post-test compared to 1.5% pre-test) or part-time (21.3% post-test compared to 2.2% post-test). The variation between pre-test and post-test could reflect true changes in employment status or it could reflect participants understanding the answer categories in different ways. The high number of respondents reporting don t know in the pre-test may be due to high rates of employment in the informal sector. Table 5: Reported Employment Status (# and %) of participants Pre- Test Post- Test Unemployed 62 (45.6%) 67 (49.3%) Employed Full-Time 2 (1.5%) 16 (11.8%) Not employed due to disability 9 (6.6%) 10 (7.4%) 3 29 Employed part-time Don't know (2.2%) 60 (44.1%) (21.3%) 14 (10.3%) As seen with data on age, level of education, and employment status, there were significant, unexplained discrepancies between participants pre and post test marital status reports. Table 6 shows the proportion of single participants almost tripled from pre-test to post-test while the number of married individuals decreased by almost half. The other categories did not see changes that were as dramatic. Single Table 6: Reported Marital Status Unmarried Partners Married Divorced Widowed Separated Pre-Test 18% 14% 54% 6% 1% 7% Post Test 50% 17% 27% 2% 1% 1% 21

22 3.2 Research Question 1: What are the most problematic parenting practices in Liberia? Based on focus group discussions from Phase I of the pilot parenting project with the IRC staff, EPAG trainers, and program participants and data from the 2007 DHS (LISGIS, 2007) and the Bridging Refugee Youth and Children s Services (2009) report, common parenting practices in Liberia include 13 : Badly beating children is a common way of disciplining children in Bentol, Liberia. 1) forcing a child to go without food; --Program participant in Doe 2) mocking a child in public; 3) locking a child in a room; 4) putting pepper on a child s eyes, noses, mouth and genitals; 5) beating a child forcefully with the hand, fist or objects or kicking a child; and 6) burning a child with hot spoons, boiling water, or wax. During the focus group discussions that were held in September, participants and trainers were asked: What kind of discipline do Liberian parents use to train children, to make children do what they expect? Do you hit them, punish them, give them gifts? Beating children was the most frequently mentioned method of discipline and often involved using fists or objects like sticks or slippers or kicking the child. Although many participants spoke of having loving families or supportive adults in their lives, many also mentioned having themselves been beaten. Two participants in Redlight summed up the inter-generational nature of the practice. Holding up her fist, one participant said, Our parents hit us, and we hit our children. Another agreed: We treat them like we saw from our mothers, hit them, *keep them+ all day without food. Another discipline practice mentioned in Phase I focus group discussions by participants, trainers, and the IRC staff members was putting pepper on children s eyes, nose, mouth, and genitals. According to one trainer: One day, I was reading my papers, and I saw a child misbehaving I saw how his mother shook the kid, and put paper with spicy pepper in his mouth, nose, anus, and penis. That is why children are so strong! The kid was punished because he left to bike for a day without saying goodbye. There is some indication, however, that the practice of peppering is less common among the younger generation, or at least less common among program participants. As stated by a program participant in Doe: My mother will pepper me everywhere, nose, eyes, ears, sex. I do not do that to my children. It was our parents. 13 Currently, national child protection systems in Liberia lack the capacity to monitor and collect data on child abuse so the only national data available comes from the 2007 DHS. 22

23 Some alternative discipline methods mentioned included mocking children, forcing children to go without food, and locking them in a room. We beat the children. We got beat, one participant in Doe said. If you whip the child they get used to it, so you hold the child s food hungry. According to another participant, You can also lock them in a room or you force the child with blocks on the hands or holding your ears and go up and down. We call [this] pump tired. Only two participants mentioned talking to the child as an effective alternative to corporal punishment. One in Doe stated, I used to beat my children. But they did not understand me. Now talking it works better. The beating was making worse as the child was used to it. Another participant mentioned that she had begun talking to her children rather than beating them when then got older because beating them became more difficult: I used to beat my children, she said, but when they started being old teenagers I talked to them now, because they are big. When I finish my body is not ok I go and take tablet (medicine). Burning children with hot spoons, boiling water, or wax was also mentioned as a method of discipline in more than one focus group discussion. As mentioned by a program participant in New Kru Town: Some parents beat their kids with rod, slap, slippers and sometimes any odd object. Some uses stick, some uses hot pepper; some burn their kids with fire candle and hot oils, etc. Across all groups, discipline was largely equated with physical punishment. Children living in foster-care or with step parents were reported as particularly at risk for physical abuse and servitude, being forced to earn their keep. One participant in Redlight noted this, saying: Especially if it is a step- child, it is not strange that the child is a slave for the family. My older sister had a little girl living with her. She was not going to school. She was fetching fresh water and clean when while my sisters children would go to school. During the focus group discussions participants were asked to discuss common methods of disciplining children in Liberia but they weren t asked to identify which ones were most problematic. There were no focus group discussions organized with children to validate what adults said during this assessment. 3.3 Research Question 2: Can the group of young mothers acquire parental skills through a short training program? Do young parents change parental behaviour or are they willing to change their parenting behaviours after a parenting skills training? Data show that the pilot parenting program appears to have been modestly successful. AAPI-2 results indicate that participants in the pilot parent program developed more positive parenting beliefs across the 5 NPP constructs, moving away from high-risk parenting beliefs. Qualitative data from focus group discussions suggests that at least in some cases, participants changed their parenting behavior. 23

24 Acquisition of parental skills The methodology used in this pilot project significantly limits our ability to identify whether, as a result of a short parenting program, young mothers acquire parental skills. The AAPI-2 measures beliefs, not skills or competencies, and indicators or methods for measuring parenting skills or competencies were not part of the research. Despite the limitations of the research, qualitative data from the focus group discussions conducted in each of the five communities at the end of the program provide anecdotal information (through self-evaluation methodology) suggesting that many participants and trainers can identify specific knowledge they have gained. They were also taught parenting techniques like time-out, dialogue, ignoring, praising, setting family rules, feelings management, etc. Examples of improved knowledge across communities included information about children s brain and emotional development: What touched *participant x+ most in the session is that mothers need to hold their baby after birth at which time the baby and parent begin to know each other. She was also touched when she learned that crying is a form of communication- when babies crying are communicating a need (Trainer, Bentol). I remember learning about how we as a parent should help our children handle their feelings. I learned that praising children can make children know that we parents are proud of what they do. And that they children and feel good because they pleased their parents (Participant, New Kru Town). The girls interviewed all said the parenting program was good, and new to them. And that they were taught the different stages children grow, how their brain develop and that they need to spend time with their child/children (Trainer, Westpoint). Participants also identified the importance of empathy and alternatives to corporal punishment. For example: For me personal the program have made me change, I as a parent should not expect too much from children, I have develop empathy and also how to discipline children with dignity not through corporal punishment (Trainer, Doe). I enjoyed every lesson in this package as they help to shape my behaviour toward my kids. I show them love, empathize with them and praise them when did something good (Participant, Bentol). *I+ learned that punishment is different from discipline and that the best form of discipline for younger kids is timeout (Participant, Bentol). There is also qualitative evidence suggesting some participants have successfully applied the knowledge they gained during the pilot parenting program. One participant, for example, told the following story about using time out with her child: 24